Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies.
Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:
a. Sex hormones
b. Trauma or inflammation
c. A dietary change
d. Scurvy
Question 2 Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?
a. Varicella
b. Herpes zoster
c. Syphilis
d. Rubella
Question 3 Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?
a. Aspirin
b. NSAIDs
c. Opioids
d. Antihistamines
Question 4 If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:
a. Iritis
b. Allergic conjunctivitis
c. Viral conjunctivitis
d. Bacterial conjunctivitis
Question 5 A 19 year old basketball player complains of itching in the crural folds, buttocks, and upper thighs. The lesions are well demarcated and are half-moon shaped. The area is red, irritated, and there are small breaks in the skin from scratching. What is this patient’s diagnosis and how should it be treated?
a. Tinea cruris; treat with a topical antifungal cream
b. Eczema; treat with a topical steroid
c. Scabies; treat with permethrin cream
d. Syphilis; treat with penicillin
Question 6 The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?
Fever history
Tender, swollen anterior cervical lymph nodes
Positive rapid antigen detection test
A and B only
A, B, and C
Question 7 Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:
a. Herpes simplex
b. Aphthous ulcers
c. Candidiasis
d. Oral cancer
Question 8 Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:
a. Quit smoking
b. Maintain aggressive hypertension therapy
c. Stick to a low-fat, low-sodium diet
d. Continue with his exercise program
Question 9 Which of the following statements about malignant melanomas is true?
a. They usually occur in older adult males
b. The patient has no family history of melanoma
c. They are common in blacks
d. The prognosis is directly related to the thickness of the lesion
Question 10 A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?
Prescribe an antifungal powder for application between her toes and in her shoes and a topical prescription strength antifungal cream for other affected areas. Monitor for a secondary bacterial infection.
Prescribe an oral antifungal for 4 to 12 weeks. Monitor BUN and creatinine at 1 week, 2 weeks, and every month thereafter.
Prescribe an oral antifungal for 4 to 12 weeks. Monitor liver enzymes, BUN, and creatnine at 1 week, 2 weeks, and every month thereafter.
Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection.
NRNP6531 Advanced Practice Care of Adults Across the Lifespan
Week 5 Knowledge Check
Question 1 Other than smoking cessation, which of the following slows the progression of COPD in smokers
a. Making sure the environment is free of all pollutants
b. Eliminating all pets from the environment
c. Engaging in moderate to high levels of physical activity
d. Remaining indoors with air conditioning as much as possible
• Question 2 Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?
a. Xanthines
b. Antihistimines
c. Steroids
d. Anticholinergics
• Question 3 A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?
a. A long-acting bronchodilator
b. An inhaled corticosteroid and cromolyn
c. Theophylline and a short acting bronchodilator
d. A bronchodilator PRN and an inhaled corticosteroid
• Question 4 Risk factors for acute arterial insufficiency include which of the following?
a. Recent myocardial infarction
b. Atrial fibrillation
c. Atherosclerosis
d. All of the above
• Question 5 Which of the following best describes hypertrophic cardiomyopathy?
a. A weakened and enlarged myocardium
b. Poor ventricular filling and weakened myocardium
c. Enlarged left ventricle and septum
d. None of the above
• Question 6 Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?
a. It is not effective during an acute asthma attack.
b. It may take 2 to 3 days to begin working.
c. This drug works within 10 minutes.
d. This drug may be used by patients 6 years and older.
• Question 7 A patient presents to the office with a blood pressure 142/80. This patient is classified as having:
a. Normal blood pressure
b. Prehypertension
c. Stage 1 hypertension
d. Stage 2 hypertension
• Question 8 What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?
a. Asthma
b. Emphysema
c. Chronic obstructive lung disease
d. Chronic bronchitis
• Question 9 Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?
a. Increase her Lisinopril to 20mg daily
b. Add a thiazide diuretic to the Lisinopril 5mg daily
c. Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker
d. Discontinue the Lisinopril and start a diuretic
• Question 10 Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?
a. Mild intermittent
b. Mild persistent
c. Moderate persistent
NRNP6531 Advanced Practice Care of Adults Across the Lifespan
Week 8 Knowledge Check
• Question 1 Diagnostic confirmation of acute leukemia is based on:
a. Bone marrow aspiration and biopsy
b. Pancytopenia
c. Hyperuricemia
d. All of the above
• Question 2 Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? a. Difficulty initiating a urine stream
b. Nocturia
c. Urinary retention
d. Increased force of urine flow
• Question 3 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?
a. Doxycycline 100 mg qd
b. Nitrofurantoin 100 mg qd
c. Bactrim DS qd
d. Erythromycin qd
• Question 4 Reed-Sternberg B lymphocytes are associated with which of the following disorders: a. Aplastic anemia
b. Hodgkin’s lymphoma
c. Non Hodgkin’s lymphoma
d. Myelodysplastic syndromes
• Question 5 Microalbuminuria is a measure of:
a. Total urinary protein.
b. Late renal compromise in a diabetic patient.
c. Early glycemic abnormality.
d. Protein lost into the urine.
• Question 6 Which of the following are classic features of ulcerative colitis?
a. Right lower quadrant pain, frequently accompanied by a palpable mass, fever, and leukocytosis.
b. Painful hematemesis, occasionally accompanied by melena.
c. Rapidly progressive dysphagia with ingestion of solid foods, anorexia, and weight loss out of proportion to the dysphagia.
d. Remissions and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain and weight loss.
• Question 7 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:
a. Oral ciprofloxacin (Cipro)
b. Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone
c. Oral trimethoprim-sulfamethoxazole (Bactrim DS)
d. Intramuscular penicillin
• Question 8 Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid?
a. Apples
b. Peppermint
c. Cucumbers
d. Popsicles
• Question 9 Of the following choices, the least likely cause of cough is:
a. Asthma
b. Gastroesophageal reflux
c. Acute pharyngitis
d. Allergic rhinitis
Question 10 Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?
a. Hypertriglyceridemia and low high-density lipoprotein (HDL)
b. Gestational diabetes and polycystic ovarian syndrome
c. Hispanic, African-American, Native-American, and Pacific Islander ethnicity
d. Postprandial hypoglycemia
NRNP6531 Advanced Practice Care of Adults Across the Lifespan
Week 10 Knowledge Check
• Question 1 The correct treatment for ankle sprain during the first 48 hours after injury includes: a. Alternating heat and ice, and ankle exercises.
b. Resistive ankle exercises, ankle support, and pain relief.
c. Rest, elevation, compression, ice and pain relief.
d. Referral to an orthopedist after x-rays to rule out fracture.
• Question 2 Which of the following statements about multiple sclerosis (MS) is correct? a. MS is a chronic, untreatable illness that is almost always fatal.
b. MS is a disease of steadily progressive and unrelenting neurologic deterioration.
c. MS is a chronic, treatable illness with unknown cause and a variable course.
d. Patients with MS who take active steps to improve their health have the best cure rate.
• Question 3 A positive drawer sign supports a diagnosis of:
a. Sciatica
b. Cruciate ligament injury
c. Meniscal injury
d. Patellar ligament injury
• Question 4 The 4 classic features of Parkinson’s disease are:
a. Mask-like facies, dysarthria, excessive salivation, and dementia.
b. Tremor at rest, rigidity, bradykinesia, and postural disturbances.
c. Depression, cognitive impairment, constipation and shuffling gait.
d. Tremor with movement, cogwheeling, repetitive movement, and multi-system atrophy.
• Question 5 A typical description of a tension headache is:
a. Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea.
b. Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain.
c. Hemicranial pain that is accompanied by vomiting and photophobia.
d. Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes, and may be preceded by nausea and vomiting.
• Question 6 The most effective treatment of non-infectious bursitis includes:
a. Systemic antibiotic therapy effective against penicillin resistant Staphylococcus areus.
b. Rest, an intra-articular corticosteroid injection, and a concomitant oral NSAID.
c. A tapering regimen of oral corticosteroid therapy.
d. Frequent active range of joint motion.
• Question 7 A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior?
a. Dementia
b. Delirium
c. Medication reaction
d. Depression
• Question 8 A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is:
a. Radial tunnel syndrome
b. Ulnar collateral ligament sprain
c. Olecranon bursitis
d. Lateral epicondylitis
• Question 9 Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:
a. Ulnar tunnel syndrome
b. Carpal tunnel syndrome
c. Tarsal tunnel syndrome
d. Myofascial pain syndrome
• Question 10 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? a. Osteoporosis
b. Constipation
c. Depression
d. Exopthalmia
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